There are so many facets to T1D which can lead to curiosity and questions. Today I’m sharing my answers to common questions. Stay tuned if you want to learn (a lot more) about MY T1D.
How many times per day to I check my blood sugar? It varies but on average I check my blood sugar 8-12 times per day. The more I check, the better my control is. If I’m wearing a continuous glucose monitor (CGM) I am able to test less using my finger because the devices checks it for me, I only have to test to calibrate the device. I am not currently using a CGM but I have in the past. I hope to begin using a CGM again in the future.
When do I have to check my blood sugar? I prick my finger, draw blood, and use my glucometer to test: first thing in the morning (before I even get out of bed), before meals, 2 hours after meals, after I take insulin to correct (lower) a high blood sugar, and before bed. I would also check my blood sugar if I was having symptoms of a high or low blood sugar (more on that below) and before driving for an extended period of time.
What is my blood sugar supposed to be? My fasting blood sugar (first thing in the morning before any food or drink) should be 80-100. After a meal my blood sugar will increase. I prefer for it to not be higher than 150. This is still considered high and would need to be lowed (using insulin) but the lower the high number, the easier it is to correct. Does that make sense? Ha!
What is insulin? Insulin is a hormone produced by the pancreas that regulates the amount of glucose in the blood. Since my immune system decided to attack my pancreas, my body does not produce its’ own insulin. I must inject man-made insulin via a syringe, pre-filled insulin pen, or insulin pump.
How many times per day do I need to inject insulin? It varies depending on how many times per day I eat. Currently I am taking two types on insulin. One is injected once per day (this one works in my body for 24 hours) and the other is injected before each time I eat (this one works quickly and wears off in a few hours).
What is basal insulin? Basal insulin involves taking a longer acting form of insulin to keep my blood glucose levels stable/consistent through periods of fasting (when I’m not eating). The current basal insulin I’m using is the one I take once daily and works in my body for 24 hours. It is made to release slowly over that time period and mimic part of what my body would do on its’ own if my pancreas worked. The brand name of the insulin I am currently taking for this is Tresiba.
What is an insulin bolus? An insulin bolus involves all of the other insulin I take outside of the one mentioned above. This is the insulin I inject before I eat as well as to correct a high blood sugar. I take this insulin 5-10 minutes before I eat because this is how long it takes to begin working in my body. The brand name of the insulin I am currently taking for this is Novolog.
How do I know how much insulin to take? I have to count the quantity of carbohydrates I plan to eat before each meal and know what my insulin to carbohydrate ratio is. The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. After a little math, I am able to dose how many units I need to cover the food. The goal here is to avoid my blood sugar going to high after meals. If my blood sugar is still high after a meal chances are I did not count the carbohydrates correctly and gave too little insulin.
What is a Hemoglobin A1c (HbA1c)? This is a blood test that tells you your average level of blood sugar over the past 2 to 3 months. HbA1c is a protein on the surface of red blood cells that sugar molecules stick to for the life of the red blood cell (which is about 3 months). The higher the level of glucose in the blood, the higher the level of HbA1c is detected on the red blood cells. The normal range for a person without Diabetes is 4% – 5.9%. For me? It should always be under 7%. The percentages coordinate with an average during the 3 months. For example an HbA1c of 5% means the average blood sugar was 100. I have this test done at my Endocrinology office every 3 months and it gives them an idea how well I’ve been managing my numbers. Decreasing this level by just 1% decreases the risk of complications (damage to retinas, nerve damage, kidney disease) by 10%!
What are my most common symptoms when I have low blood sugar? Tingling lips, sweating, mental confusion, slow to respond to questions, fatigue, shakiness, lightheadedness, blurred vision, slurred speech, irritability, pale skin. This is a very scary situation for me especially if it happens in the middle of the night.
What do I need to do if I have a low blood sugar? I need to supply my body with fast acting carbohydrates QUICKLY before the situation becomes a medical emergency. Sometimes, a low blood sugar can be very scary!
What snacks do I like to carry with my to treat a low blood sugar? I only need about 15 grams of carbohydrates to treat a low blood sugar. I love to use Trader Joe’s Fruit Leather, fruit snacks, or juice boxes. If I feel a low blood sugar coming on gradually and it’s not around meal time I always have a pack of peanut butter crackers with me. Combining a protein with the carbohydrates allows this to work more gradually in the body and lessens my chance of having to treat another low shortly after. This type of snack is also preferred if my blood sugar is too low to go to bed for the night.
What do you need to do if I ever pass out around you? I carry an emergency Glucogon kit with me and also keep one in my home. This medication is used to treat a severe low blood sugar which would be the reason for me loosing conscientiousness. The kit contains the medication that needs to be injected into a large muscle (the upper outer thigh tends to be the best place because it’s hard to miss).
Does my blood sugar go high or low with exercise? It goes lower. I will always decrease my insulin intake if I am somewhere that requires a lot of walking, such as the Zoo or a theme park. I have to be careful during an strenuous activity that my blood sugar is not going low in the process. Often symptoms of strenuous activity and a low blood sugar can feel the same. When in doubt, I must test to be sure. It’s also helpful to plan ahead and start those types of activities when my blood sugar is a little high so that I have more room for it to fall without causing me an issue.
What are my most common symptoms when I have high blood sugar? Extreme and insatiable thirst, urinary frequency, headaches, brain fog, fatigue, increase in hunger despite possible nausea.
What do I need to do if I have a high blood sugar? I need to administer the proper amount of rapid acting insulin after checking my blood sugar to confirm how high it is. Since I am not currently on an insulin pump I do the math for this on my own using my insulin sensitivity factor. The insulin sensitivity factor tells you how many points, in mg/dL, your blood sugar will drop for each unit of insulin that you take. The formula is:
your current blood sugar – your target blood sugar / your sensitivity factor
Depending on how high my blood sugar is I may also need to test my urine for the presence of Ketones. More about that in another post when I explain Diabetic Ketoacidosis (DKA) in detail.
If you’ve made it to the end of this long post… congratulations and thank you for reading! Remember I am always open to questions, you just have to ask!
sugarnspicediabetes 